Your Guide to Medicare Part A
Medicare is a federal health insurance program for people age 65 and older and some younger Americans with certain disabilities and illnesses. Medicare is made up of four different parts: Part A (hospital insurance), Part B (medical insurance), Part C (an alternative to Parts A and B offered by private insurers) and Part D (prescription drug insurance).
What is Medicare Part A?
Original Medicare is made up of two parts: Medicare Part A and Medicare Part B. Medicare Part A provides coverage for inpatient care, including care received in a hospital, skilled nursing facility and sometimes, at home.
What Does Medicare Part A Cover?
Medicare Part A is hospital insurance. It covers the hospital charges and certain expenses you have during a hospital stay, including meals, operating room fees, necessary medical supplies and lab tests. Medicare Part A also covers inpatient hospital care required as part of a clinical research study.
However, Medicare Part A doesn’t cover doctor fees and hospitalizations—Medicare Part B covers these. Benefits won’t extend to medically unnecessary expenses like private duty nursing or personal care items.
Hospital care
When you’re admitted to a hospital, Medicare Part A covers most of your costs for up to 60 days. You’re responsible for paying a benefit period deductible. This period begins the day you are admitted and ends when you have been out for 60 days in a row.
- Semi-private rooms
- All meals, including special or medically-necessary diets
- General Nursing
- Care received in a special unit, such as Intensive Care and Coronary Care
- Drugs, medical supplies and medical equipment used during your inpatient stay
- Lab tests and X-rays completed during your inpatient stay
- Operating room and recovery room services
- Rehabilitation services received during your inpatient stay
- Some blood transfusions
Skilled nursing facility stays are covered under Medicare Part A following a related inpatient hospital stay. To qualify for skilled nursing facility care, you must enter the SNF within a short time (generally 30 days) of leaving the hospital and require skilled services related to your hospital stay.
Medicare Part A covers a semi-private room, meals and a range of services provided by the skilled nursing facility, including rehabilitation services, medications and medication administration, tube feedings, wound care and dietary counseling.
Home healthcare servicesMedicare Part A covers home healthcare services when deemed medically necessary and ordered by your healthcare professional. These services include part-time or intermittent care, including physical therapy, speech-language pathology, occupational therapy, home health aide, and medical social services.
- Usually, a home health care agency coordinates the services your doctor orders for you. The home health aide services would be included in eligible benefits order by your doctor.
Medicare Part A covers the entire cost of home healthcare services. However, if your doctor orders durable medical equipment for your use at home, this is covered under Medicare Part B. You are responsible for 20% of the Medicare-approved amount.
Hospice
If a provider diagnoses you terminally ill (six months or less to live), Medicare Part A will offer compassionate hospice care. This gentle care focuses on relieving pain and keeping you comfortable. You are covered to receive hospice care if you need it. Typically, these services are provided in your home.
- Doctor services and nursing care
- Pain relief medications
- Social services
- Durable medical equipment and medical supplies
- Hospice aide services
- Homemaker services
- Physical therapy
- Occupational therapy
- Dietary counseling
- Short-term inpatient care, if required for pain or symptom management
To receive hospice care through Medicare Part A, you must agree to stop curative treatments. However, you have the right to stop hospice care and restart curative treatments at any time.
Remember that neither Medicare Part A nor Medicare Part B covers prescription drugs. Prescription drug coverage requires enrollment in a Medicare Part D plan or a Medicare Part C plan that includes prescription drug benefits.
How Much Does Medicare Part A Cost?
For most people, Medicare Part A is free—meaning you pay no premiums—if you or your spouse worked and paid Social Security taxes for at least 10 years.
For more information, please visit: Part A costs | Medicare
When and How Can I Sign Up for Medicare Part A?
If you’re turning 65 and are already receiving or are registered to begin receiving benefits from Social Security or the Railroad Retirement Board (RRB), you are automatically enrolled in Medicare Part A.
If you are not getting Social Security benefits (i.e., if you’re still working), you will need to enroll in Medicare Part A. You can complete Medicare Part A enrollment by contacting Social Security. To avoid any late penalty payments, you’ll want to complete your Medicare Part A application during your Initial Enrollment Period (IEP). Your IEP spans seven months—the three months before your 65th birthday month, and the three months after your birthday.
Understanding the four Medicare parts and their combinations can be confusing. That’s why HelloMedicare™ is here to help. Reach out to a licensed insurance agent today by calling: +1-877-343-4684, TTY: 711 to review your Medicare options for complete coverage at a cost that works for you.